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temporary exclusive pumping/bottle feeding: bad idea?

My baby girl is 5 weeks old and the nursing pain is getting worse daily for me. The pediatrician (who is also a lactation consultant) thinks the baby might have posterior tongue tie, but we have to wait for her to come back from vacation and then get special blood tests for the baby before we can get a proper diagnoses and procedure. Meanwhile, my pain increases daily to where it's become totally unbearable in the last few days. Also, my baby is becoming increasingly fussy at the breast, and wiggling around with my breast in her mouth, which makes it all so much worse.

On the pediatrician's recommendation, I've been pumping to increase my supply (also painful and not working) and giving the baby formula to make sure she gains enough weight. I'm seeing my own doctor on Monday for my pain, but I'm thinking to get me through the weekend, I might exclusively pump for a couple days and bottle feed the baby and see if the pain decreases at all. Is this a horrible idea? Will my baby forget her latch completely over a weekend? Thanks!

Re: temporary exclusive pumping/bottle feeding: bad idea?

So sorry you have been having such terrible pain!
If nursing is unbearable, then pumping and giving your baby your pumped milk is not a terrible plan. There are risks, but if the only other option is to stop nursing entirely due to the pain, then it is a good plan, because then you can keep your milk supply up or at least in pretty good shape which means you will not also be battling supply issues on top of everything else. It will certainly not help baby latch better, and getting baby to relearn nursing at the breast may indeed be a challenge, but baby is not going to completely "forget" how to latch this young as this is an innate instinct.

But to make this work best, there are a few things you will want to consider doing: 1) You should be using a hospital grade rental pump. No other pump will do what you need. And make sure the pump is in good condition, working correctly, and the breast shells are the right size. Pumping should NOT EVER hurt, if it does that is defeating the whole purpose. Adjust the setting to one that is comfortable for you.

2) If baby is not nursing at all, aim for at least 10 pumping sessions per day. Don’t fret overmuch about how much you make, and don’t pump forever each time- I think about 15-20 minutes on both sides at once (or that much for each side if you prefer to not double pump) is the usual recommendation. Wht you pump does not tell you how much yo aer capable of making, as no pump is as affective as a well nursing baby, adn some moms really struggle with pumping any volume. But if you cannot nurse, you ahve to just keep pumping frequently with a good pump. Try hand expression and breast compressions to help get more out.

3) feed baby in as breastfeeding a supportive way as possible. Since the issue is a painful latch, an at the breast supplementer is not going to work. So you could consider cup feeding, spoon feeding, syringe feeding, and paced bottle feeding. Feed baby slowly, SMALL amounts (2 ounces or so) at a time with great frequency (10-12 times a day or more) to be the most like breastfeeding.

Hold baby lots, cuddle, let baby still comfort on you. If you start feeling up to it, maybe let baby nurse here and there. Experiment with different positioning ideas to see if one is more comfortable. And make sure you are protecting your nipples and helping them heal. (Look into breast shells, try lanolin, expressed milk, salt water bathing etc. for helping nipples heal.)

If the issue truly is tongue tie, the sooner that is taken care of the better, really. If it was me no way would I be waiting for someone to get back from vacation. A baby being unable to nurse is a SERIOUS health concern and your hcp should be treating it as such. (many do not, this is when you have got to advocate for your baby.) Can you see an ENT? Some pediatric dentists also treat tt. Ask around, really there should be no more delay in treatment. TT release is a pretty simple procedure. What would the blood tests be for-could you baby have a bleeding disorder?

Re: temporary exclusive pumping/bottle feeding: bad idea?

For the pumping, get a hospital grads pump, and make sure your horns are the right size. That can make a big difference in pumping, both in comfort and in output. Adjust e setting slowly to where it works, and don't forget to do breast compressions. Relying on the suction alone is a sure-fire way to drop your supply.

Pump every 2 hours around the clock. Shoot for 120 minutes broken into those sessions. Pumping overnight is very important in these early days.

I would find an ENT ASAP. Not sure why they need bloodwork...several of my friends have had posterior TT babies, and none needed bloodwork.

Could you have thrush? I had extreme pain for about 9 months while EPing for my cleft baby, and it finally went away when I did some pretty extreme thrush treatments and used a hospital grade pump as my only pump.

Re: temporary exclusive pumping/bottle feeding: bad idea?

The PPs gave excellent advice. I just want to add that if you decide to pump for a few days, keeping the baby at the breast just for a couple feedings per day may help her retain her latching skills and willingness to nurse. You also want to make bottle-feeding as much like breastfeeding as possible by doing the following:
- Keep the bottles small, just 2-3 oz
- Use slow-flow bottle nipples
- When it's time to nurse, open your shirt and cuddle baby close to bare skin. Tickle her lips with the bottle until she opens WIDE- don't let her learn sloppy latch habits from getting a bottle slipped into a half-open mouth.
- Pause the feeding after every ounce or so, to give baby a chance to read her own satiation cues.

Re: temporary exclusive pumping/bottle feeding: bad idea?

I was wondering if you need to use formula? This seems to be a sure way to decrease your supply even more. If you need to due to not having enough milk shown by baby not producing enough wet diapers or weight gain concerns (over a long period, not day to day) then you need to, but I just worry that you might be working against yourself by supplementing with formula. Also, keep up the good work. Nursing is hard work and it sounds like you are trying hard despite the additional challenges.

Re: temporary exclusive pumping/bottle feeding: bad idea?

Thanks for all the encouragement, information and advice. I’ve been pumping all day and nursing once per day for a few days now. It’s definitely helped with the pain, but when I do nurse, it’s still horrible. I do have a hospital pump, which works great. Now that I’ve been nursing less often each day, the pumping hurts less.

The reason for the blood test is that her father has a genetic bleeding/clotting disorder, which the doctor wants to know about before the procedure. I appreciate her caution.

I have tried swaddling during nursing. It helps sometimes but not others. Regarding getting her to open wide, that rarely happens. Occasionally I can get her to do it, but she always instantly pulls away and readjusts herself to purse her lips around my nipple. If I insist on no pursed lips, she’ll just fuss and never nurse. I think that’s a tongue tie thing, yes?

The formula was recommended by the doctor to help her gain wait. She didn’t gain any weight for her first three weeks, and she was nursing for 3, 4, or 5 hours at a time. So our pediatrician/lactation consultant advised the formula supplement to get her weight up while I pump to get my supply up. Her weight went up the next week, so it worked out well.

We’re back at the doctor’s on Monday, but I doubt we’ll have our blood results back by then, so it may be awhile longer before we can get this problem fixed. Meanwhile, pumping every two hours is really tough logistically when I’m home alone, and the baby can take a couple of hours or more to settle down enough for me to get 15-20 minutes away from her flailing arms. We do use the swaddle a lot, but if it’s not done at the exact right moment, she’ll get inconsolably fussy, so it doesn’t always prove useful. Does anyone have advice for managing the logistics of pumping every two hours while alone with a tiny baby?

Re: temporary exclusive pumping/bottle feeding: bad idea?

What else have you tried besides swaddling when latching? Swaddling is not something that typically helps with a painful latch, in my experience. If it helps, great, of course.

Some babies just do not open wide. They never gape, don't make flared or fish lips, look like the are 'nipple nursing" and it is fine & does not hurt mom. The various issues from tt is due to the tongue not being mobile/long enough to do what it needs to do during nursing, so even a baby with a perfect gape is going to hurt mom and not be able to nurse effectively if tongue tied. If taking baby on and off over and over is not working, you could try gently pushing more of your breast into baby’s mouth after she has latched. Again, many moms dealing with painful latch find that adopting a more “laid back” breastfeeding position helps with the pain.

As far as pumping when alone with baby, that is a toughy. When I needed to pump with my oldest I never pumped double sided so I held baby with one hand and pumped with the other, but of course that made pumping sessions twice as long.

Also, you can turn a cheap sports bra into a hands free pumping bra, you cut holes to fit the breast flanges in. I am just a little concerned if you are still having nipple injury you want to be very careful about flange placement.